Opportunistic screening of atrial fibrillation by automatic blood pressure measurement in the community

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Open Access

Research

Opportunistic screening of atrial fibrillation by automatic blood pressure measurement in the community Stefano Omboni,1 Willem J Verberk2,3

To cite: Omboni S, Verberk WJ. Opportunistic screening of atrial fibrillation by automatic blood pressure measurement in the community. BMJ Open 2016;6:e010745. doi:10.1136/bmjopen-2015010745 ▸ Prepublication history for this paper is available online. To view these files please visit the journal online (http://dx.doi.org/10.1136/ bmjopen-2015-010745). Received 2 December 2015 Revised 17 February 2016 Accepted 24 February 2016

ABSTRACT Objective: Timely detection of atrial fibrillation (AF) may effectively prevent cardiovascular consequences. However, traditional diagnostic tools are either poorly reliable ( pulse palpation) or not readily accessible (ECG) in general practice. We tested whether an automatic oscillometric blood pressure (BP) monitor embedded with an algorithm for AF detection might be effective for opportunistic screening of asymptomatic AF in the community. Setting: A community-based screening campaign in an unselected population to verify the feasibility of AF screening with a Microlife WatchBP Office BP monitor with a patented AFIB algorithm. When possible AF was detected (≥2 of 3 BP measurements reporting AF), a doctor immediately performed a single-lead ECG in order to confirm or exclude the presence of the arrhythmia. The main demographic and clinical data were also collected. Participants: 220 consecutive participants from an unselected sample of individuals in a small Italian community.

Primary and secondary outcome measures:

1

Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy 2 Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands 3 Microlife AG, Widnau, Switzerland Correspondence to Dr Stefano Omboni; stefano.omboni@iitelemed. org

Number of patients detected with AF and diagnosed risk factors for AF. Results: In 12 of 220 participants, the device detected possible AF during the BP measurement: in 4 of them (1.8%), the arrhythmia was confirmed by the ECG. Patients with AF were more likely to be older (77.0±1.2 vs 57.2±15.2 years, p=0.010), obese (50.0 vs 14.4%, p=0.048) and to suffer from a cardiovascular disease (50.0 vs 10.6%, p=0.014) than patients without AF. Participants with a positive BP AF reading and non-AF arrhythmias (n=8) did not differ in their general characteristics from participants with a negative BP AF reading and were younger than patients with AF (mean age 56.4±14.8, p=0.027; 5 of 8 participants aged